(Solution) American Journal of Epidemiology The Author 2012. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public... > Snapessays.com


(Solution) American Journal of Epidemiology The Author 2012. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public...


i need help critiquing the article attached below applying criteria outlined by Arshengrau and Seage ( 2008)American Journal of Epidemiology

 

ª

 

The Author 2012. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

 

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial

 

License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use,

 

distribution, and reproduction in any medium, provided the original work is properly cited.

 

Original Contribution

 

Role of Tobacco Use in the Etiology of Acoustic Neuroma

 

Sadie Palmisano, Judith Schwartzbaum, Michaela Prochazka, David Pettersson,

 

Tommy Bergenheim, Rut Florentzson, Henrik Harder, Tiit Mathiesen, Gunnar Nyberg, Peter Siesjo

 

¨,

 

and Maria Feychting

 

*

 

*

 

Correspondence to Dr. Maria Feychting, Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm 171 77,

 

Sweden (e-mail: [email protected]).

 

Initially submitted July 6, 2011; accepted for publication November 15, 2011.

 

Two previous studies suggest that cigarette smoking reduces acoustic neuroma risk; however, an association

 

between use of snuff tobacco and acoustic neuroma has not been investigated previously. The authors conducted

 

a case-control study in Sweden from 2002 to 2007, in which 451 cases and 710 population-based controls completed

 

questionnaires. Cases and controls were matched on gender, region, and age within 5 years. The authors estimated

 

odds ratios using conditional logistic regression analyses, adjusted for education and tobacco use (snuff use in the

 

smoking analysis and smoking in the snuff analysis). The risk ofacoustic neuroma was greatly reduced in male current

 

smokers (odds ratio (OR)

 

¼

 

0.41, 95% con±dence interval (CI): 0.23, 0.74) and moderately reduced in female current

 

smokers (OR

 

¼

 

0.70, 95% CI: 0.40, 1.23). In contrast, current snuff use among males was not associated with risk of

 

acoustic neuroma (OR

 

¼

 

0.94, 95% CI: 0.57, 1.55). The authors’ ±ndings are consistent with previous reports of lower

 

acoustic neuroma risk among current cigarette smokers than among never smokers. The absence of an association

 

between snuff use and acoustic neuroma suggests that some constituent of tobacco smoke other than nicotine may

 

confer protection against acoustic neuroma.

 

acoustic neuroma; cigarette smoking; smoking; snuff; snus; Swedish snuff; tobacco; vestibular schwannoma

 

Abbreviations: CI, con±dence interval; OR, odds ratio; RR, risk ratio; TSNA, tobacco-speci±c nitrosamine.

 

Acoustic neuroma, also known as vestibular schwannoma, is

 

a benign, slow-growing tumor affecting Schwann cells of the

 

eighth cranial nerve. It comprises approximately 8%–10% of all

 

intracranial tumors (1–3). Schwann cells are peripheral nervous

 

system cells that produce a myelin sheath around neuronal

 

axons. Common presenting symptoms for acoustic neuroma

 

include hearing loss, tinnitus, and lossofbalance; however, large

 

untreatedtumors can potentially lead to brain stem compression,

 

hemorrhaging, and death, although these outcomes are rare (4).

 

Incidence estimates vary from 1 to 20 cases per million per year

 

(5), with more recent estimates placing incidence between 11

 

and 13 cases per million per year (2). Although the incidence

 

appears to be increasing over time (3, 5–7), it is unclear whether

 

this signals a true increase or is due to improved diagnostic

 

technology, changes in completeness of reporting, or both.

 

Several risk factors for acoustic neuroma have been identi-

 

?ed through previous research. The inherited genetic condi-

 

tion neuro?bromatosis type 2 has been associated with

 

bilaterally presenting acoustic neuroma cases; however, these

 

bilateral tumors account for fewer than 5% of all acoustic

 

neuroma diagnoses (6). Less is known about the etiology of

 

acoustic neuroma cases presenting unilaterally, even though

 

these 1-sided tumors account for the majority of cases. Studies

 

ofchildrenwhoreceiveddosesofradiotherapyfortineacapitis

 

(8) and atomic bomb survivors (9) have linked moderate to

 

high doses of ionizing radiation to increased acoustic neuroma

 

risk. Risk factors including loud noise (10–12), mobile phone

 

use (13), and some occupational hazards (14) have also been

 

investigated, but these results have been inconclusive.

 

Two studies found a protective effect of cigarette consump-

 

tion on acoustic neuroma risk. Schoemaker et al. (15) noted that

 

ever smokers were at a reduced risk of acoustic neuroma com-

 

pared with never smokers (odds ratio (OR)

 

¼

 

0.7, 95% con?-

 

dence interval (CI): 0.6, 0.9), and current smokers enjoyed even

 

Am J Epidemiol.

 

2012;175(12):1243–1251

 

1243

 

Vol. 175, No. 12

 

DOI: 10.1093/aje/kwr465

 

Advance Access publication:

 

April 19, 2012

 


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